Journal of the American College of Radiology : JACR
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The aim of this study was to assess 15-year trends in nonprocedural clinical evaluation and management (E&M) services provided by interventional radiologists (IRs). ⋯ Interventional radiologist claims for nonprocedural clinical encounters with Medicare fee-for-service beneficiaries increased 12-fold over the 15 years from 1993 to 2008, as payment denial rates dropped by half. Evaluation and management services by IRs have grown fastest in the private office setting, which now represents the single most common location of these services.
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Mentoring in academic medicine has been described on a multitude of levels in medical literature, but seldom with respect to medical students. In fact, although some fields have addressed mentoring in the context of medical student education, radiation oncology has yet to do so in a comprehensive fashion. ⋯ They present a paradigm for promoting mentorship through traditional classroom-based and nontraditional socially and research-based initiatives. It is the authors' hope that both radiation oncology and other specialties will benefit from the initiation of this discussion, as well as build on the suggestions detailed here as we prepare the next generation of radiation oncologists.
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The aims of this study were to collect data relating to radiation dose delivered by multidetector CT scanning at 10 hospitals and private practices in Queensland, Australia, and to test methods for dose optimization training, including audit feedback and didactic, face-to-face, small-group teaching of optimization techniques. ⋯ Audit feedback and small-group teaching about optimization enabled clinically meaningful dose reduction for a variety of common adult scans. However, access to medical radiation physicists, assistance with time-consuming data collection, and technical support from a medical imaging technologist were costly and critical to the success of the program.
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Comparative Study
Medicare's physician quality reporting initiative: incentives, physician work, and perceived impact on patient care.
The aims of this study were to compare incremental radiologist work to incremental financial incentives under Medicare's Physician Quality Reporting Initiative (PQRI) and to evaluate physicians' perceptions of the program's impact on the quality of care. ⋯ Even when aggressively pursued, Medicare's pay-for-performance program, PQRI, yields actual physician bonuses far less than those expected, more than an order of magnitude less than requisite incremental radiologist work, with little reported impact on quality. For such programs to engender ongoing physician participation, fundamental changes will be necessary to address discordantly low incentives and perceived lack of benefit to patient care.